Characteristics of Patients With Spontaneous Splenic Rupture

Abstract

In the present study, we aim to share our clinical experience in patients with spontaneous splenic rupture. Splenic rupture without trauma is known as spontaneous splenic rupture. The major problems in the management of spontaneous splenic rupture are missed or delayed diagnosis due to the lack of trauma in most cases. The records of all patients, who were admitted to Cerrahpaşa Medical Faculty, Istanbul University, were retrospectively reviewed from January 2000 to March 2013. Twelve patients were admitted to the emergency department and they were diagnosed with spontaneous splenic rupture. The mean age was 47.6 years. All patients had complaints of abdominal pain. The mean hematocrit value was 22%. Radiologic assessment revealed hemoperitoneum and/or subcapsular hematoma in 8 patients while splenic abscess was diagnosed in 2 patients. Eleven patients underwent splenectomy whereas one was managed conservatively. The most common cause of spontaneous splenic rupture was determined to be use of anticoagulants. Etiology was considered to be idiopathic in 1 patient. Two patients died in the postoperative period. Although rare, spontaneous splenic rupture must be suspected in emergency patients who have used especially anticoagulants and antiaggregants and who have had no recent history of trauma. One of the important causes of mortality is missed or delayed diagnosis.

Splenic rupture in community acquired pneumonia: A case report

“…sepsis secondary to a primary infective process) rather than prompting clinicians to consider an atraumatic splenic rupture. A high index of suspicion and a thorough work-up is essential as a missed or delayed diagnosis increases the risk of mortality [19]. In our case the splenic rupture could not have been anticipated or prevented.…”

“…Diagnosis can be made on CT in haemodynamically stable patients only. Otherwise it may be identified on bedside ultrasonography or intraoperatively [15], [19]. Further investigations depend on the suspected aetiology and may entail a work-up for suspected malignant, infective and/or inflammatory disorders.…”

Spontaneous Splenic Rupture in the Early Postoperative Period to After Lobectomy

“…Although the available data are limited, its frequency has been reported to be 0.1% to 0.5%. Cases of spontaneous splenic rupture commonly in the literature as case reports; however, in the study by Kocael et al [5], including a series of 12 cases, the most frequent cause of spontaneous splenic rupture has been reported to be the use of anticoagulants. Systemic diseases (amyloidosis, hepatitis, etc.)…”

“…and malignancies play roles in its etiology. Further, there are idiopathic cases without any cause [5]. Hemodynamic support and emergency splenectomy are primarily recommended as soon as a diagnosis has been made, according to the clinical situation of a patient.…”

“…However, a patient must be closely followed up. Studies have reported a mortality rate of approximately 12.2% https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC4254229/ however, in patients with a malignancy, splenomegaly, advanced age, and delayed diagnosis, the risk of mortality further increases [1,5].…”